Provider Demographics
NPI:1134434129
Name:MURRAY, BETH ANN (MS,NP)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:ANN
Last Name:MURRAY
Suffix:
Gender:F
Credentials:MS,NP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1743 N OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11763-2649
Mailing Address - Country:US
Mailing Address - Phone:631-758-3336
Mailing Address - Fax:631-758-9709
Practice Address - Street 1:5537 EXPRESSWAY DR N
Practice Address - Street 2:
Practice Address - City:HOLTSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11742-1316
Practice Address - Country:US
Practice Address - Phone:631-758-3336
Practice Address - Fax:631-758-9709
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-13
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY30-305517363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health